Clark, Kristen M

Clark, Kristen M is an individual health care provider with primary practice located at 593 Eddy St , Providence RI 02903-4923. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, Critical Care, which is considered as her primary health care specialty. Clark, Kristen M can be contacted via phone (401) 444-4201.

Contact Information

Primary practice address
593 Eddy St Providence RI 02903-4923
Phone: (401) 444-4201
Fax: (401) 444-5527
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, Critical Care 363LP0222X NPP37652 Rhode Island

Profile Details

NPI number 1851668602
LBN Legal business name Clark, Kristen M
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 22nd, 2011
Last updated Nov 22nd, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851668602 NPPES
Rhode Island Other NPP37652 LICENSE

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